Asian Journal of Surgery (Jul 2025)

Does the type of neoplasm influence the development of postoperative complications following distal pancreatectomy? A multicenter prospective snapshot study from the Spanish distal pancreatectomy project (SPANDISPAN)

  • Belinda Sanchez-Pérez,
  • Candido F. Alcazar-Lopez,
  • Mario Serradilla-Martin,
  • Celia Villodres-Tudela,
  • Belen Hernández,
  • Julio Santoyo Santoyo,
  • Jose Manuel Ramia,
  • Juli Busquets,
  • Luis Secanella,
  • Nuria Peláez,
  • Maialen Alkorta,
  • Itziar De Ariño Hervas,
  • Mar Achalandabaso Boira,
  • Enrique Toledo,
  • Fernando Rotellar,
  • Pablo Martí-Cruchaga,
  • Miguel Ángel Gómez-Bravo,
  • Gonzalo Suárez,
  • Marina Garcés-Albir,
  • Luis Sabater,
  • Gabriel García,
  • Francisco Javier Alcalá,
  • Enrique Asensio,
  • David Pacheco,
  • Esteban Cugat,
  • Francisco Espín,
  • María Galófre,
  • Jorge Calvo,
  • Carmelo Loinaz,
  • M.I. García-Domingo,
  • Santiago Sánchez-Cabús,
  • Belén Martín,
  • Gerardo Blanco-Fernández,
  • Isabel Jaen-Torrejimeno,
  • Carlos Domingo del Pozo,
  • Carmen Payá,
  • Carmen González,
  • Sandra Ruiz,
  • Rafael López-Andújar,
  • Cristina Ballester,
  • Ana Belén Vico,
  • Natalia Zambudio,
  • Sergio Estévez,
  • Manuel Nogueira-Sixto,
  • José Ignacio Miota,
  • Belén Conde,
  • Miguel Ángel Suárez,
  • Jorge Roldán de la Rua,
  • Angelica Blanco,
  • Manuel González,
  • Pilar Elena González,
  • Betsabé Reyes,
  • Santiago López Ben,
  • Berta Tió,
  • Javier Mínguez García,
  • Inmaculada Lasa Unzúe,
  • Alberto Miyar,
  • Lorena Solar,
  • Fernando Burdio,
  • Benedetto Ielpo,
  • Alberto Carabias,
  • María Paloma,
  • Alfredo Escartín,
  • Fulthon Vela,
  • Elia Marqués,
  • Adelino Pérez,
  • Gloria Palomares,
  • Antonio Calvo,
  • José Tomás Castell,
  • María Jesús Castro,
  • M. Carmen Manzanares,
  • Enrique Artiguez,
  • Juan Luis Blas,
  • Luis Diez,
  • Alicia Calero,
  • Luis Muñoz,
  • Mario Rodríguez,
  • Daniel Aparicio-Lopez,
  • Juan J. Rubio-Garcia

DOI
https://doi.org/10.1016/j.asjsur.2025.04.182
Journal volume & issue
Vol. 48, no. 7
pp. 4137 – 4143

Abstract

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Introduction: The morbidity associated with left pancreatectomy (LP) is estimated at 20–25 % for major complications, with a mortality rate of 1–3 %. Diagnosing incidental pancreatic lesions, combined with an aging population and increased comorbidities, presents complex therapeutic challenges. This uncertainty raises the question of whether LP presents different morbidity and mortality profiles depending on the neoplasm type, potentially aiding decision-making. Objective: To compare postoperative outcomes by tumor type in a prospective series of LPs in Spain. Methods: The SPANDISPAN Project is a prospective, multicenter, observational study conducted in hepato-pancreato-biliary units from February 2022 to January 2023. A total of 311 patients from 41 Spanish centers participated. Patients were categorized by etiology: Adenocarcinoma (ADC), Intraductal Papillary Mucinous + Mucinous Cystic Neoplasms (IPMN + MCN), Neuroendocrine Tumors (NET), and Others. Pancreatic surgery-specific complications were defined by the International Study Group on Pancreatic Surgery (ISGPS). Results: Postoperative complications were similar overall and for Clavien-Dindo grade > II. No significant differences were observed in POPF, except that grade B/C was more frequent in NET (29.6 %, p < 0.039), mainly due to grade B (53.3 %). No differences were found in PPH or DGE, though the severity of hemorrhage differed significantly (p < 0.035), with grade B more common in Others and grade C in NET (66.7 %). Conclusion: No significant differences in complication rates were found based on etiology. Non-functioning NETs in elderly patients should be carefully assessed due to the increased severity of POPF, PPH, and reoperation rates.

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